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Wednesday, April 8, 2015

The Burden Of Tuberculosis

Health authorities should devote more efforts to containing the
disease

Tuberculosis, better known by its acronym TB, still constitutes a major health
problem in Nigeria.

This much was brought to
the fore last week at the World TB Day in Abuja.

The World Health
Organisation (WHO) 10-year strategy (2006-2015) to cut down the burden of TB in
the world worked elsewhere as it reportedly saved some 37 million lives while some
countries succeeded in halving the prevalence of the disease. But in Nigeria,
the reverse is the case.

According to the National TB and Leprosy Control Programme (NTBLCP), over
600,000 new cases of tuberculosis have occurred in Nigeria, the highest in
Africa, from a global report conducted in 2014.

Indeed, WHO has ranked
Nigeria third out of 22 countries with high prevalence of TB in the world.

The world health body is particularly worried because a substantial number of
the people infected in Nigeria are unreported or undiagnosed.

Dr. Rui Gama Vaz, WHO
country representative in Nigeria said some 15 per cent of the three million
people undiagnosed for TB around the world are in Nigeria, most of them women
and children in slum neighbourhoods where poor ventilation and squalor abet the
spread of the disease.

“If you do not reach those
women and children infected”, said Vaz, “they will continue to spread TB in
their communities.”

Tuberculosis is perhaps the single leading cause of death from any single
infectious agent.

It is caused by a
bacterium which most commonly affects the lungs and transmitted from person to
person through air droplets.

TB affects all species of
vertebrates and though control measures had reportedly limited the spread
through animals, they (particularly cattle) still constitute a significant
source of risk in countries like Nigeria where meat and milk inspection by
health officials are often overlooked.

“You cannot have good
public health unless you have good animal health,” said James Steele. “And you
cannot have good animal health unless you have good public health”.

Globally, some 13 per cent of TB patients are also afflicted with HIV, and said
to be the leading cause of death among people living with HIV.

But tuberculosis is a curable disease. However, that is dependent on early
detection and correct diagnosis aided with proper treatment.

Many patients afflicted
with TB do not complete the TB therapy and even worse, many do not make
themselves available for treatment.

Indeed, failure to
complete the treatment and the mismanagement of drugs had led to the death of
many patients and the increase in variants of the disease that are
drug-resistant.

Nigeria has the second
highest multi-drug resistance tuberculosis (MDR-TB) burden in Africa and the
13th highest in the world.

Ironically, current
efforts are not enough to find, treat and cure people suffering from the
ailment even though treatment centres for drug-resistant TB have grown from one
in 2010 to 12 in 2014.

Some 15 states are said to
have initiated treatment of drug-resistant TB patients in their communities.
Dr. Gabriel Akang, National Coordinator, NTBLCP said the directly
observed treatment short course (DOTS) services are currently provided in about
6000 health facilities in the country, and diagnosis in 1515 microscopy
laboratories.

DOTS is said to be a cost-effective strategy that consists of physically
observing patients as they take the TB medications to ensure treatment
compliance.

It reportedly has shown
cure rates of up to 95 per cent in relatively poorer countries.

Last week, the Minister of
Health, Dr. Khaliru Al-Hassan said the NTBLCP and the National Agency for the
Control of AIDS (NACA) in collaboration with partners have increased capacity
for diagnosis of TB among persons living with HIV and drugs-resistant TB
through the installation of new diagnostic machines across the nation.

But also heartening is the
promise to search the urban slums and communities to fish out the patients.

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